Click on the image above to view a higher resolution image. Click on the link for a PDF copy of the Death and Burial Record of Rozalia Dymek. Translated from the Polish, the record reads:

41 Piasutno

This happened in the village of Mały Płock on the twentieth day of February / fourth day of March in the year one-thousand eight-hundred fifty-nine at the hour of ten in the morning. There appeared Paweł Dymek, father of the deceased, forty years of age, and Ignacy Dymek, paternal uncle, thirty years of age, both peasant farmers residing in Piasutno, and they stated that on the day before yesterday at the hour of ten in the morning, Rozalia died in Piasutno, ten years of age, born in this village, daughter of the married couple, the afore-mentioned Paweł and Maryanna née Kaczmarczyk Dymek, a peasant farmer residing in Piasutno. After visual confirmation of the death of Rozalia, this document was read aloud to the illiterate declarants and was signed only by Us.
[signed] The Reverend Franciszek Sakowicz, Pastor of Mały Płock, Maintaining the Records of the Civil State